Infection Control & Prevention

MRSA stands for Methicillin resistant Staphylococcus Aureus. It is a bacteria (germ) that has become resistant to many of the commonly used antibiotics; Methicillin is one of those antibiotics.

This is a common form of bacteria, which lives quite happily on the skin of about 30% of the population without causing problems or infections. This is called colonisation. Staphylococcus aureus, like many other germs can cause infections ranging from minor infections such as skin boils to more serious infections such as septicaemia (blood poisoning) This is more likely in those who are already unwell, have lowered immunity and wounds.

We have known about MRSA since the 1960's but it is now becoming more of a problem in hospitals and is widespread in the community. If MRSA causes an infection then less commonly used antibiotics may need to be used which often take longer to work. These antibiotics are usually given intravenously (by injection) which often means the patient has to stay in hospital for their treatment.

It is usually spread by person-to-person contact mainly by the hands. This is why hand hygiene by everyone is so important. MRSA is also found in dusty environments. MRSA may be acquired both in hospital and the community.

At St Anthony’s we take infection control very seriously and work continuously to reduce the risk of cross infection from MRSA and all other infections. St Anthony’s does not discriminate against patients who are known to be MRSA carriers but if they need to be admitted then we have strict source isolation procedures to negate the risk of cross infection.

Clostridium Difficile is a major cause of antibiotic related diarrhoea in healthcare. It mostly affects elderly people and those with underlying conditions. It is a bacteria which is spore forming which allows it to survive well in the environment. It lives happily in the gut of about 35% of babies and 5% of healthy adults without causing harm or infections. It is normally kept in check by healthy bacteria in the gut. It usually only causes an infection when the healthy (good) bacteria are killed off by antibiotics. This allows the Clostridium difficile bacteria to multiply and irritate the lining of the gut causing diarrhoea. When an infection occurs this causes diarrhoea ranging from very mild to very severe. In very rare and extreme cases the gut may perforate. The diarrhoea is often smelly, watery or bloody. The patient may suffer abdominal cramps and a raised temperature.

Mostly the elderly with serious underlying conditions, patients who have been on broad spectrum antibiotics, particularly those treated for chest infections. Clostridium difficile may be acquired both in hospital and the community as well as nursing homes. Fit healthy people are not at risk.

Mostly by cross infection from another patient. Either by direct contact with the diarrhoea or patient or via the health care workers hands or contaminated equipment.

Yes by specific antibiotics.

• Good hand washing with soap and water is imperative as the clostridium difficile spores are resistant to alcohol gel.
• All rooms at St Anthony’s are single and en-suite which allows affected patients to be source isolated and all patients have their own bathroom facilities.
• Clostridium difficile is resistant to many cleaning agents but chlorine is the most effective agent to clean and kill the spores. All cleaning staff are dedicated to their own area and have training in decontaminating and thoroughly cleaning equipment and the environment to a high standard and effectively.
• Careful use of antibiotics is encouraged at St Anthony’s and on call advice from a consultant microbiologist is available to all our consultants and resident doctors.

There are over 100 different types of Clostridium difficile. Until recently, type 027 was rare in the UK and it was first identified in 1999. In 2004-2005 there were outbreaks in Stoke Mandeville and Exeter hospitals and more recently at Maidstone and Kent hospital. This type appears to produce more toxins and causes more severe infection which can spread rapidly between patients.